Occupational Asthma Reference

Jones M, Welch J, Turvey J, Cannon J, Clark P, Szram J, Cullinan P, Prevalence of sensitization to ‘improver’ enzymes in UK supermarket bakers, Allergy, 2016;71:997-1000,10.1111/all.12854
(Plain text: Jones M, Welch J, Turvey J, Cannon J, Clark P, Szram J, Cullinan P, Prevalence of sensitization to 'improver' enzymes in UK supermarket bakers, Allergy)

Keywords: UK, baker, enzymes, IgE, , maltogenic amylase, cellulase, xylanase, lipase, glucose oxidase, amylase

Known Authors

Paul Cullinan, Royal Brompton Hospital, London, UK Paul Cullinan

Meinir Jones, Royal Brompton Hospital, London Meinir Jones

Julie Cannon, Royal Brompton Hospital London Julie Cannon

Joanna Szram, Royal Brompton Hospital Joanna Szram

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Supermarket bakers are exposed not only to flour and alpha-amylase but also to other ‘improver’ enzymes, the nature of which is usually shrouded by commercial sensitivity. We aimed to determine the prevalence of sensitization to ‘improver’ enzymes in UK supermarket bakers.

We examined the prevalence of sensitization to enzymes in 300 bakers, employed by one of two large supermarket bakeries, who had declared work-related respiratory symptoms during routine health surveillance. Sensitization was determined using radioallergosorbent assay to eight individual enzymes contained in the specific ‘improver’ mix used by each supermarket.

The prevalence of sensitization to ‘improver’ enzymes ranged from 5% to 15%. Sensitization was far more likely if the baker was sensitized also to either flour or alpha-amylase. The prevalence of sensitization to an ‘improver’ enzyme did not appear to be related to the concentration of that enzyme in the mix.

We report substantial rates of sensitization to enzymes other than alpha-amylase in UK supermarket bakers; in only a small proportion of bakers was there evidence of sensitization to ‘improver mix’ enzymes without sensitization to either alpha-amylase or flour. The clinical significance of these findings needs further investigation, but our findings indicate that specific sensitization in symptomatic bakers may not be identified without consideration of a wide range of workplace antigens

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The study reports IgE assays of workers from two supermarket scratch bakeries who had work-related upper or lower respiratory symptoms found on surveillances questionnaires. There was positive IgE to flour and/or amylase in 22% of samples from one bakery and 40% from the other. 66% of the samples had positive IgE to other enzymes, but this was rare in workers without positive tests to flour or amylase. Enzymes tested were lipase, maltogenic amylase, cellulose, fungal xylanase, bacterial xylanase, glucose oxidase and bacterial alpha amylase It is unclear whether the enzymes tested were genetically engineered versions in common use or the original unmodified enzymes

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